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Review
. 2021 Dec 7:11:151-168.
doi: 10.2147/PTT.S342911. eCollection 2021.

Non-Alcoholic Fatty Liver Disease (NAFLD) in Patients with Psoriasis: A Review of the Hepatic Effects of Systemic Therapies

Deepak M W Balak  1   2 , Stefano Piaserico  3 , Ismail Kasujee  4
Affiliations
Review

Non-Alcoholic Fatty Liver Disease (NAFLD) in Patients with Psoriasis: A Review of the Hepatic Effects of Systemic Therapies

Deepak M W Balak et al. Psoriasis (Auckl). .

Abstract

There is increasing interest in the association between psoriasis and non-alcoholic fatty liver disease (NAFLD), which is a prevalent liver disease characterized by excessive fat storage and inflammation that can progress to fibrosis and cancer. Patients with psoriasis have a two-fold higher risk to develop NAFLD and a higher risk to progress to more severe liver disease. Psoriasis and NAFLD share common risk factors such as smoking, alcohol consumption, and the presence of metabolic syndrome and its component disorders. In addition, both psoriasis and NAFLD hinge upon a systemic low-grade inflammation that can lead to a vicious cycle of progressive liver damage in NAFLD as well as worsening of the underlying psoriasis. Other important shared pathophysiological pathways include peripheral insulin resistance and oxidative stress. NAFLD should receive clinical awareness as important comorbidity in psoriasis. In this review, we assess the recent literature on the epidemiological and pathophysiological relationship of psoriasis and NAFLD, discuss the clinical implications of NAFLD in psoriasis patients, and summarize the hepatotoxic and hepatoprotective potential of systemic psoriasis therapies.

Keywords: Nrf2-activation; fumaric acid esters; non-alcoholic fatty liver disease; psoriasis.

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Conflict of interest statement

DMWB is a consultant/speaker for AbbVie, Almirall, Celgene, Eli Lilly, Galderma, Janssen, LEO Pharma, Novartis, and Regeneron/Sanofi Genzyme. IK is an employee of Almirall, Barcelona, Spain. SP is a consultant/speaker for AbbVie, Almirall, Celgene, Eli Lilly, Galderma, Janssen, LEO Pharma, Novartis, UCB, and Pfizer. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Spectrum of non-alcoholic fatty liver disease (NAFLD). Data from these studies.,
Figure 2
Figure 2
Common risk factors and associations between psoriasis (PsO) and non-alcoholic fatty liver disease (NAFLD). Reprinted from Prussick RB, Miele L. Non-alcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden? Br J Dermatol. 2018;179(1):16–29. © 2018 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.
Figure 3
Figure 3
Possible mechanisms linking dysfunctional visceral adipose tissue, psoriatic skin and steatosis.
Figure 4
Figure 4
Proposed mechanisms of action of dimethyl fumarate/monomethyl fumarate (DMF/MMF).
See this image and copyright information in PMC

References

    1. Armstrong AW, Mehta MD, Schupp CW, et al. Psoriasis prevalence in adults in the United States. JAMA Dermatol. 2021;157(8):940–946. doi:10.1001/jamadermatol.2021.2007 - DOI - PMC - PubMed
    1. Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263–271. doi:10.1016/S0140-6736(07)61128-3 - DOI - PubMed
    1. Balato N, Megna M, Palmisano F, et al. Psoriasis and sport: a new ally? J Eur Acad Dermatol Venereol. 2015;29(3):515–520. doi:10.1111/jdv.12607 - DOI - PubMed
    1. Gisondi P, Bellinato F, Girolomoni G, et al. Pathogenesis of chronic plaque psoriasis and its intersection with cardio-metabolic comorbidities. Front Pharmacol. 2020;11:117. doi:10.3389/fphar.2020.00117 - DOI - PMC - PubMed
    1. Prussick RB, Miele L. Non-alcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden? Br J Dermatol. 2018;179(1):16–29. doi:10.1111/bjd.16239 - DOI - PubMed

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